Cited by 719Health disparities and outcomesPublic Health and Social InequalitiesAging, Health, and Disability

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Socioeconomic status and health: The role of subjective social status

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Demakakos, Panayotes, Nazroo, James, Breeze, Elizabeth, Marmot, Michael·2008·Social Science & Medicine

DOI 10.1016/j.socscimed.2008.03.038PMC PMC2547480

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Abstract

Studies have suggested that subjective social status (SSS) is an important predictor of health. This study examined the link between SSS and health in old age and investigated whether SSS mediated the associations between objective indicators of socioeconomic status and health. It used cross-sectional data from the second wave (2004-2005) of the English Longitudinal Study of Ageing, which were collected through personal interviews and nurse visits. The study population consisted of 3368 men and 4065 women aged 52 years or older. The outcome measures included: self-rated health, long-standing illness, depression, hypertension, diabetes, central obesity, high-density lipoprotein cholesterol, triglycerides, fibrinogen, and C-reactive protein. The main independent variable was SSS measured using a scale representing a 10-rung ladder. Wealth, education, and occupational class were employed as covariates along with age and marital status and also, in additional analyses, as the main independent variables. Gender-specific logistic and linear regression analyses were performed. In age-adjusted analyses SSS was related positively to almost all health outcomes. Many of these relationships remained significant after adjustment for covariates. In men, SSS was significantly (p<or=0.05) related to self-rated health, depression, and long-standing illness after adjustment for all covariates, while its association with fibrinogen became non-significant. In women, after adjusting for all covariates, SSS was significantly associated with self-rated health, depression, long-standing illness, diabetes, and high-density lipoprotein cholesterol, but its associations with central obesity and C-reactive protein became non-significant. Further analysis suggested that SSS mediated fully or partially the associations between education, occupational class and self-reported and clinical health measures. On the contrary, SSS did not mediate wealth's associations with the outcome measures, except those with self-reported health measures. Our results suggest that SSS is an important correlate of health in old age, possibly because of its ability to epitomize life-time achievement and socioeconomic status.

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Background
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Result
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“In developed countries, the gradient in the association between socioeconomic status and health is well documented with individuals of higher status living longer, enjoying better health, and experiencing less disability [23,34-39].”
Background
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“Recently, subjective perception of social class has been proposed by some to have a stronger influence on health than objective measures of social status (SinghManoux et al. 2003, 2005; Demakakos et al. 2008).”
Background
When Couples Become Grandparents: Factors Associated with the Growth of Each Spouse
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Background
Social Fairness Researches in Perspectives of Social Class Psychology
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“…et al., 2012)。很多研究都表明, 对于要考察的因变量 , 主观阶层比客观阶层的预测力更强 (Kraus et al., 2013; 胡小勇等, 2014), 因此越来越多的研究者强调对主观阶层的关注(王春光, 李炜, 2002; Kraus & Stephens, 2012)。目前比较主流的思路是在研究中综合考察主客观阶层, 有的是在一个研究中分别检验主客观阶层的独立效应 (Kraus, Côté, & Keltner, 2010; Kraus, Piff, & Keltner, 2011), 有的是在结构方程模型中将主客观作为两个显变量合成为一个阶层潜变量(周春…”
Subjective socioeconomic status, health, and early-life conditions
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“Most studies who looked at the correlates of SSS point to income, education, and occupation as being the best predictors of SSS (Andersson, 2018; Miyakawa et al., 2012; Singh-Manou et al., 2003), and the general view is that SSS epitomizes lifetime achievements and SES (Demakakos et al., 2008).”
Background
Patient reported interpersonal processes of care and perceived social position: The Diabetes Study of Northern California (DISTANCE)
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“Previous work has shown a robust association of perceived social position with health [25,32,58].”
Background
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“Recently, there has been an increasing interest in exploring the relationship between subjective SES and health disparities [3-7].”
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“Both objective and subjective socioeconomic indicators have been implicated (Demakakos et al. 2008).”
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“This is consistent with previous findings in other marginalized and minority populations (N. Adler et al., 2008; Cundiff & Matthews, 2017; Demakakos et al., 2008; Goodman et al., 2007; Ostrove et al., 2000).”
BackgroundResultInfluential
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“, 2000), as well as self-reported results, such as depression (Demakakos et al., 2008) or perceived stress (Hamad et al.”
Background
Association between the Physical Activity of Korean Adolescents and Socioeconomic Status
Oh, I., Lee, G., Oh, C., Choi, K., Choe, B., Choi, J., & Yoon, T. (2009) · Journal of Preventive Medicine and Public Health · doi:10.3961/jpmph.2009.42.5.305 · Cited by 19
“[36]”
Resilience, Death Anxiety, and Depression Among Institutionalized and Noninstitutionalized Elderly
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Sex Differences in Associations Between Subjective Social Status and C-Reactive Protein in Young Adults
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“(10)), lower SSS is associated with higher inflammation when adjusting for oSES indicators.”
Background
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Reitzel, L. R., Childress, S. D., Obasi, E. M., Garey, L., Vidrine, D. J., McNeill, L. H., & Zvolensky, M. J. (2016) · Behavioral Medicine · doi:10.1080/08964289.2016.1150805 · Cited by 19
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“Respondents’ perception of their social positions is also found to be a significant predictor of health (Cundiff et al. 2011; Demakakos et al. 2008).”
Socioeconomic predictors of smoking cessation in a worldwide online smoking cessation trial
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Second-class citizens? Subjective social status, acculturative stress, and immigrant well-being
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“This status–depression association has also been supported with SSS (Black and Krishnakumar 1998; Collins and Goldman 2008; Cutrona et al. 2005; Demakakos et al. 2008; Everson et al. 2002; Hoffman and Hatch 2000; Singh-Manoux et al. 2003).”
Result
Socio-economic status and trajectories of a novel multidimensional metric of Active and Healthy Ageing: the English Longitudinal Study of Ageing
Malkowski, O. S., Kanabar, R., & Western, M. J. (2023) · Scientific Reports · doi:10.1038/s41598-023-33371-0 · Cited by 18
Changes in self-rated health and subjective social status over time in a cohort of healthcare personnel
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“A series of studies that asked participants to place themselves on a 9- or 10-step ladder relative to others in the United States in terms of education, income, and occupational status have observed associations between SSS and self-rated health status (SRH) and medical conditions (Adler et al., 2000, 2008; Demakakos…”
BackgroundInfluential
Well-being in older age: a multidimensional perspective
Demakakos, P., McMunn, A., & Steptoe, A. (2010) · UCL Discovery (University College London) · Cited by 20
A Longitudinal Assessment of Perceived Discrimination and Maladaptive Expressions of Anger Among Older Adults: Does Subjective Social Power Buffer the Association?
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“Although brief, this measure has been shown to have a high degree of predictive validity for mental health outcomes (e.g., Adler et al., 2008; Cundiff, Smith, Uchino, & Berg, 2013; Demakakos et al., 2008).”
Background
Does Low Subjective Social Status Predict Cognitive Decline in Chinese Older Adults? A 4-Year Longitudinal Study From Hong Kong
Kim, J. H., Sumerlin, T. S., Goggins, W. B., Kwong, E., Leung, J. C. S., Yu, B. W. M., & Kwok, T. C. Y. (2021) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2021.01.014 · Cited by 18
Does relative material wealth matter for child and adolescent life satisfaction?
Hudson, E. M. (2013) · The Journal of Socio-Economics · doi:10.1016/j.socec.2013.06.007 · Cited by 17
Explaining subjective social status in two countries: The relative importance of education, occupation, income and childhood circumstances
Lindberg, M. H., Chen, G., Olsen, J. A., & Abelsen, B. (2021) · SSM - Population Health · doi:10.1016/j.ssmph.2021.100864 · Cited by 17
“The most studied health outcome in this regard is self-rated health (see e.g., Demakakos et al., 2008; Präg, 2020), but subjective SEP has also been found to predict outcomes such as mortality (Demakakos et al., 2018), depression (Singh-Manoux et al., 2003), cortisol levels (Wright & Steptoe,…”
Background

Authors: Demakakos, P., Nazroo, J., Breeze, E., & Marmot, M.
Affiliations: University College London (GB)
University of Manchester (GB)
Corresponding author: Demakakos, Panayotes
ORCID: Demakakos, Panayotes
Nazroo, James
Breeze, Elizabeth
Marmot, Michael
Venue: Social Science & Medicine
Publisher: Elsevier BV
Published: 2008-07
Volume: 67
Issue: 2
Pages: 330-340
ISSN: 0277-9536 (ISSN-L)
DOI: 10.1016/j.socscimed.2008.03.038
PMC: PMC2547480
OpenAlex: W2032784487
Cited by: 719
References: 46
Citations by year: 2026: 31 · 2025: 52 · 2024: 54 · 2023: 53 · 2022: 55 · 2021: 51 · 2020: 36 · 2019: 41 · 2018: 50 · 2017: 45 · 2016: 40 · 2015: 32 · 2014: 41 · 2013: 30 · 2012: 32
FWCI: 26.58
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Social Science & Medicine (publishedVersion)
PubMed (publishedVersion)
Research Explorer (The University of Manchester) (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
RePEc: Research Papers in Economics (submittedVersion)
UCL Discovery (University College London) (submittedVersion)
Funders: British Heart Foundation (RG/07/008/23674)
Economic and Social Research Council (RES-000-23-0590)
National Institute on Aging (2R01AG7644-01A1, R01AG013196, R01AG017644)
Topics: Social Sciences › Health › Health disparities and outcomes
Social Sciences › Health › Public Health and Social Inequalities
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
Keywords: subjective social status, socioeconomic status, elderly health, self-rated health, depression, chronic disease, mediation, occupational class, wealth, gender differences, fibrinogen, C-reactive protein, English Longitudinal Study of Ageing
MeSH terms: Aged, Aged, 80 and over, Cross-Sectional Studies, Female, United Kingdom, Health Status Indicators, Humans, Interviews as Topic, Longitudinal Studies, Male, Middle Aged, Social Class

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Socioeconomic status and health: The role of subjective social status

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